Innovation in the public sector is about renewing or creating something new that creates value for citizens, businesses and/or society or organizational innovation. TISK IKT has created solutions in all four groups. Partly we have created solutions that are completely new - for example the system for local pandemic tracking with travel and test data, as well as the Covid-19 certificate.

In addition, we have created solutions that are somewhat new variants/additions on a known basis - for example a contact register for municipal doctors based on an existing national Address Registry. Moreover, we have taken familiar solutions to be used used in a new way - for example one health region's laboratory requisition solution which, with a bit of remodeling, became the new Rapid Test Portal. Last, but not least, we have seen organisational innovation bringing several agencies together in joint collaboration patterns.

Parts of TISK IKT is still live and running since there is a need for people travelling abroad to document their Covid-19-status.

• Other parts of the solution have been put to rest, ready to be re-deployed should the pandemic resurface again.
• We are regularly diffusing lessons - using what was learnt to inform other projects and understanding how the innovation can be applied in other ways.
• We are also working on project methodology in order to understand how the organisational innovation can be institutionalised

• Municipalities – user insight vital to develop most useful solutions
• GPs – user insight based on their contact with patients
• Companies – technical know-how for agile development of solutions

• Citizens – solutions for self-service (time scheduling, test results, Covid-19 passports)
• Health personnel – solutions to report test results to registries and to citizens
• Municipalities – solutions for enhanced pandemic tracking and monitoring

Health test results have traditionally been communicated and explained by healthcare personnel. A digital solution on the portal "National online health services in Norway" (Helsenorge) became the main channel for sending and explaining more than 11 million test results to citizens (the entire population in Norway is 5,4 million) which would otherwise require communication in a different way or a different handling of the result. Citizens have booked time for more than 750,000 Covid-19 tests electronically, saving time both for them and healthcare personnel. The proportion of e-consultations with GPs went from approximately 5% before the pandemic to almost 30% during and after the pandemic. More than 46 million Covid-19 certificates have been downloaded. We expect the rise in citizen digital self-service via Helsenorge to stay at a high level.

Two big challenges:

1. Take a helicopter perspective frequently enough to expand and reorganize the organisation fast enough to take on an expanding list of required solutions based on new, politically decided restrictions in travel, testing, etc. At one occasion we were pretty close to a situation where too few assigned resources would unnecessarily slow down development.
2. Combining data from various registries into one pandemic monitoring system for health professionals in primary health care where more challenging than expected. It has not been fully solved yet and has to be worked on.

• Explain the common threat and nurturing a sense of urgency to the entire programme team
• A laser focus on a common purpose and goal
• Management-backed accept for taking risk beyond what is normal for civil servants
• Leadership and guidance pointing out the main direction and at the same time giving way for independent teams to work agile and coming up with good solutions and ideas
• Backing from management in each agency
• Financial resources available or provided on short notice
• A strong, enthusiastic and diverse team, respecting each other's competence and experience; and driving on each other's strengths
• Use of existing registries either holding data or being able to consume more data in a new legal framework
• Use of existing, publicly owned, digital, shared components like registries for authorization of users and log-in-identification of inhabitants

The involved organisations have looked at how the experiences could help them adjust project management practices in their own agencies. "Short and fat" projects has become a term and a goal, working more efficient in public projects compared to low-intensity, long-lasting projects that tend to consume more resources overall. The way of working in TISK IKT (particularly the pieces making several agencies working well together) has been replicated in creating digital solutions for Ukrainian refugees fleeing into Norway, which is still being further developed.

1. Set up independent teams working agile
2. To give a public project a shorter timeline than normal might help stimulate speed and still meet quality criteria
3. Hold up the purpose in order to bring good ideas forward
4. Active involvement of and an open and transparent communication with a wide range of user groups, especially the The Norwegian Association of the Blind and Partially Sighted was actively involved in the development of the Covid-19 certificate
5. Innovative use of SoMe (ie. Slack) to create a two-wide dialogue with different tech communities

Health information should and must not go astray. It is absolutely essential for citizens to have confidence in sharing sensitive information. TISK IKT has involved lawyers from the start in each individual work package - and in the entire program - to ensure that privacy and information security were safeguarded and built into the solutions right from the start. We tend to say that we have had Norway's fastest public lawyers.